• Medical Director - National Medicare

    Humana (Columbus, OH)
    …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation ... of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The… more
    Humana (03/11/25)
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  • Senior Director Medicare Ops

    Banner Health (Phoenix, AZ)
    …a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and ... operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved 4. Sets strategic… more
    Banner Health (03/16/25)
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  • Appeal Analyst Pharmacy Medicare

    Corewell Health (Grand Rapids, MI)
    …administer all steps of the Pharmacy appeal and review processes for all Medicare products in a pleasant and expedient manner to ensure quality customer service ... and compliance with all legislative, regulatory and accreditation requirements. Assist...the member appeal and ALJ hearing processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical… more
    Corewell Health (03/14/25)
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  • Associate Medical Director

    CenterWell (Henderson, NV)
    …the lives of our patients, and the healthcare industry as a whole. The Associate Medical Director serves as a health-care professional and capable of handling ... a variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities interrelate across multiple… more
    CenterWell (01/18/25)
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  • Associate Director of Quality…

    UTMB Health (Galveston, TX)
    Associate Director of Quality Management & Accreditation - Quality Management **Galveston, Texas, United States** Executive UTMB Health Requisition # 2500388 ... of the care processes surrounding patients and families. **Job Summary:** The Associate Director of Quality Management and Accreditation is responsible for… more
    UTMB Health (01/31/25)
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  • Associate Director E, Research…

    University of Pennsylvania (Philadelphia, PA)
    …and wellness programs and resources, and much more. Posted Job Title Associate Director E, Research Administration (Department of Cardiovascular Medicine) Job ... Profile Title Associate Director E, Research, Administration Job Description...(industry, etc.). Understanding and keeping current with FDA and Medicare regulations applicable to clinical trials. Understanding interaction of… more
    University of Pennsylvania (02/13/25)
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  • Associate Director , Rebate…

    Ascendis Pharma (Princeton, NJ)
    …to grow and develop their skills. Ascendis Pharma is looking to hire an Associate Director , Rebate and Contract Operations to join our team. Responsibilities ... tactical, demonstrating strong leadership, project management, and communication skills. As the Associate Director , Rebate and Contract Operations, you will be… more
    Ascendis Pharma (02/06/25)
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  • Associate Director , Corporate…

    CSL Behring (King Of Prussia, PA)
    The Associate Director , Corporate Accounts (ADCA) is responsible for optimizing access, reimbursement, and profitability for CSL Behring's portfolio of brands in ... role in CSL Behring's commercial organization and reports to the Senior Director of Corporate Accounts. The ADCA is responsible for executing CSL Behring's… more
    CSL Behring (01/09/25)
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  • Executive Director , Compliance

    NASCO (Columbus, OH)
    **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the ... company's Compliance and Privacy Official. Responsible for overseeing the company's... Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship… more
    NASCO (02/11/25)
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  • Academic Professional Track (Non-Tenure): Open…

    Texas A&M University - Faculty (Dallas, TX)
    Director of Clinical Compliance include: Under the direct supervision of the Associate Dean of Clinical Affairs, the Director of Clinical Compliance ... Academic Professional Track (Non-Tenure): Open Rank Clinical & Director of Clinical Compliance College of...eClinicalWorks, etc.) . Knowledge of managing patient care, HIPPA compliance , and centers for Medicare and Medicaid… more
    Texas A&M University - Faculty (02/12/25)
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  • Collections Specialist I - Managed Medicare

    Community Health Systems (Franklin, TN)
    …balances; identification of claim problems and resolution; standards within compliance of government and managed care contract terms. **Essential Functions** ... standards. **Qualifications** + HS Diploma or GED required + Associate Degree preferred + 0-1 years Strong interpersonal and...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
    Community Health Systems (02/06/25)
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  • Risk Adjustment Compliance Director

    Humana (Columbus, OH)
    …of our caring community and help us put health first** The Risk Adjustment Compliance Director ensures compliance with governmental requirements. The Risk ... Adjustment Compliance Director requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Risk… more
    Humana (03/11/25)
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  • Medical Director - Care Plus - Florida

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (03/18/25)
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  • Associate Center Operations Director

    ChenMed (Bradenton, FL)
    …We're rapidly expanding and we need great people to join our team. The Associate Director , Center directs and administers the day-to-day operations of a medical ... biohazard waste and medicine disposal, etc. + Conducts trainings and refreshers regarding Medicare and HIPAA compliance , ensures annual OSHA trainings occur and… more
    ChenMed (03/08/25)
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  • Associate Medical Director

    Evolent (Columbus, OH)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** ... to drive meaningful change beyond the bedside? Evolent Health is seeking an ** Associate Medical Director - Cardiovascular Medicine** to play a critical role… more
    Evolent (03/04/25)
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  • Associate Director , Field…

    AbbVie (Houston, TX)
    …Austin, Texas + San Antonio, Texas + New Orleans, Louisiana The Associate Director , Field Reimbursement Manager - Immunology Rheumatology/Dermatology manages and ... are compliant with AbbVie expectations and ways of working. The Associate Director , Field Reimbursement Manager - Immunology Rheumatology/Dermatology must… more
    AbbVie (03/07/25)
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  • Associate Director Pricing…

    Gilead Sciences, Inc. (Foster City, CA)
    Director , Contracting and Pricing Strategy, Virology, Managed Markets. As ** Associate ** ** Director of US** **Pricing** **&** **Contracting** **Strategy** **, ... Join Gilead and help create possible, together. **Job Description** As the ** Associate D** **irector of US** **Pricing** **&** **Contracting** **Strategy** , within… more
    Gilead Sciences, Inc. (01/23/25)
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  • Associate Director Ambulatory…

    Penn Medicine (Philadelphia, PA)
    …our future each day. Are you living your life's work? **Summary:** + The Associate Director ("AD") will assist in the planning, development, coordination and ... ensure that established policies, goals, and objectives are achieved and in compliance with policies and procedures, standard practices of the profession, and… more
    Penn Medicine (01/01/25)
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  • IPA Coding Associate Director

    CenterWell (Columbus, OH)
    …training program for coding staff to ensure continuous skill development and compliance with coding standards. + Partner with analytics and audit to identify ... coder errors and develop plans to address deficiencies/specific areas of focus. ** Associate Engagement and Retention:** + Develop and implement strategies to foster… more
    CenterWell (03/06/25)
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  • Physician Medical Director - LTSS

    Humana (Columbus, OH)
    …us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical authorizations to determine the ... of a given service, level of care, or medical item/supply. The Medical Director 's work assignments involve moderately complex to complex issues where the analysis of… more
    Humana (01/25/25)
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